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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
463050 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
I Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Dalstock LLC I Richmond Townshi
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
/66 /06 1 f� ( i (_ -" j 22.30.18.
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
/,6 o /.a
Septic � 3 � Benchmark
Dosing Alt. BMS G 5.z1� 7
i� a3 3
Aeration Bldg. Sewer
Holding St/Ht Inlet
0
TANK SETBACK INFORMATION St/Ht outlet ` �.� 4� l -53
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic $y If 'v , f ^ 2-1 Z � i Dt Bottom \
Dosing ► Header /Man.
Aeratio Dist. Pipe la,B --- 7 d-411
�0 (4 ! 0 3�
Holding Bot. System
Final Grade
PUMP /SIPHON INFORMATION "I , (o 3
Manufacturer Demand St Cover
GPM �.Z � ors �1 ,2
Model Number
TDH Lift Friction Loss System Ft _ i Forcemain Lena Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS J � _ t�
SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacture
INFORMATION CHAMBER OR &w
Type Of System: aim
UNIT Model Number:
z q �
DISTRIBUTION SYSTEM 'Y j
Header /Manifold IlDistribution x Hole Size x Hole Spacing Vent to Air Intake
!� es) \
Length ✓ Dia Pip
_ Length > Dia Spacing \ \�
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges \ Topsoil Yes No \' Yes No
COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / /
Location: 1474 129th Street New Richmond, WI 54017 (N 1/2 SE 1/4 22 T30N R18W ) Lundy Meadows Lot 1 Parcel No: 22.30.18.
1.) Alt BM Description = �5 ,,����fp�Sy��ij�►,G�Q
2.) Bldg sewer length = lW . �� � y/ Ida/hi - amount of cover = i ` J� S Aj ►� `(�{� �dlliYH , � l �'�
Plan revision Re
9 '5
- -
Use other side for additional information. 1 _ `
SBD - 6710 (R.3/97) Date Insepct rs Sign re Cert. No.
Required? Yes 0
f
Sanitary Permit Application Safety & Buildings Division
In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave.
See reverse side for instructions for com ion PO Box 7302
14 sconsi n personal information you provi ors . oses Madison, WI 53707 -7302
Department of Commerce (Submit completed form to county if not
m)�
state owned.)
Attach complete plans (to the county py only) for the sys pap r not less than 8 -1/2 x 11 inches in size.
County f - D' State Sanitary Permit Nu I er �J� Qhe i fsion to pre ous application State Plan I. D. Number
05 0
I. Application Information - Please Print all Informa ion U f'v Location:
Pro perty Owner Name / ,,,, (( // __ N1 -° Property Location Z
A" L Smc k- L LC i / / /O � / f" "1 S,7�T/ CN,1 /E✓(o W
Property Owner's Mailing Address- Lot Number Block Number
/ /,Zf4 r
City to / Zip Code T Phone Number Subdivision Name or CSM Number
C - t II. Type of Building: (check one) ❑ City
1 or 2 Family Dwelling - No. of Bedrooms: t r ❑ Village
❑ ublic /Commercial (describe use):_ x G ( j , y �ej Town of /
❑ State -Owned 3
f ?f / ^ Nearest Roa / �
t J/ h Parcel Tax N ber(s)
III. Type of Permit: (Check only one box on line A. Check box on line B if applicable)
A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. Addition to
System System Tank Only Existing System
$) Permit Number Date Issued
❑ A Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply)
K Non - pressurized In-ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland p 0
- Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line 3
❑ At -grade ❑ Aerobic Tre lent Unit ❑ Recirculating ❑ Other: �/
✓L C — --u s � sue. �/ L , /
V. Dispersal/Treatment Area Information: 3
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Ap ' on 5. Percolation Rate 6. S i 7. Final Grade
Required S Proposed Rate (Gals. /da /sq. ft.) (Min. /inch) T , , / _ Elevation R/
VII. Tank Capacity in Total # of Manufacturer Prefab Site -+15e Plastic Q
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structed g 7
Tanks Tanks
❑ ❑ ❑ ❑
e-e
uJA- ❑ ❑ ❑ ❑ ❑
VIII. Responsibility Statement
I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
r lumber' Name (print) Plumber's tore (no stamps): MP/MPRS No. Business Phone Number
lu is Address (Street, City, Stafe Zlp Code)
IX. County epartment Use Only
,,__,� ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Dat Issued wing A ent Sig ps)
UdApproved ❑Owner Given Initial Adverse Surcharge Fee) �C� S , d_
Determination
tpproval sons f r tsappro
1 Septic tank, effluent filter ==
dispersal cell must all be serviced I maintained
as per management plan provided by plumber. yP9`L� r ~x � S
2. se ac requiremen s mu
as per applicable code /ordinances. --nLA �S 'm e f -e�
SBD -6398 (R. 07/00 S_e�_ -�`�� u�. �,c�d�� 5 y,S 1/y► � �- ' ° "" �' � T "- (�
PLOT PLAN
PROJECT Bill Stock ADDRESS 1748 112th st NewRichmond W. 54017
N 1/4 SE 1/4S 22 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX
MPRS Byron Bird Jr. 220527 �;�,,,� r DATE 9 -13 -04 BEDROOM 4
CONVENTIONAL XXXX A rade CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1260 LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE 0 LOAD RAT 4 ABSORPTION AREA 1500 # of chambe s 49
IL BENCHMARK V.R.P. top of survey iron ASSUME ELEVATION 100'
❑ BOREHOLE O WELL *H.R.p. Same as BM
Vent SYSTEM ELEVATION T -1 =89.6 T -2 =89.4 T -3 =89.2
>12"
Of Bio Diffuser with
Cov 31.1 ft ^2 per
699 chamber
N
34" qt System
ph f pe r
Elevation
A+ 423' P
° f Garage Driveway
4 bed Hot se
315' ��"
1 C�,,/
V ` B3 S
c13" 100 ob Pipe
50'
20' �yt
'
50' PL
PLOT PLAN
PROJECT Bill Stock ADDRESS 1748 112th st NewRichmond Wi. 54017
N 1/4 SE 1 /4s 22 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX
MFRS Byron Bird Jr. 220527 DATE 9 - 13 -04 BEDROOM 4
CONVENTIONAL XXXX A rade CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1260 LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE a LOAD RATE .4 ABSORPTION AREA 1500 # of chambers 49
BENCHMARK V.R.P. top of survey iron ASSUME ELEVATION 100'
❑ BOREHOLE O WELL sH.R.p. Same as BM
Vent SYSTEM ELEVATION T -1 = 89.6 T -2 =89.4 T -3 =89.2
> 12"
Of Bio Diffuser with
Cove 31.1 ft A2 per
chamber
6 "
Long 34" Elevation
BM 423' PL
Garage Driveway
4 bed Hot se
315'
1'
1
B3 1
100 70' O ob pipe
,
50'
15'
20' 2
B ok is
50' PL
ST. CROIX COUNTY
WISCONSIN
a
.,wr►''. w. ZONING DEPARTMENT
«� s rn. ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
Hudson, WI 54016 -7710
- — Phone: (715) 386 -4680 Fax (715) 386 -4686
Memo to File
From: Pam Quinn
Date: 4/27/2004
Re: Sandy loam structure misinterpretation on subdivision sal reports
Recent soil on -site determinations have brought a problem to our attention. During these on-
sites, boaings were ex vated to confirm soil conditions where. two conflicting soil reports had
been submitted for zoni department review. The soil profiles, evaluated by myself, Dave
Fogerty, and Dave Steel (all certified soil testers) differed from the original soil reports in that
massive (structureless) sandy loams were encountered in horizons that were described as having
either moderate, medium subangular blocky (2msbk) structure by Adam Schumaker or weak,
medium granular structure (lmgr) by Shaun Bird. There apparently has been a
misunderstanding between "structure" caused by handling samples of the soil during texturing
versus the soil characteristics in situ. The soil, when chunks were taken out of the profile to hand
texture, with pressure parted into "crumbs" that appeared at first to be subangular or granular in
shape. However, these were not true peds that broke apart along planes of weakness, but
fragments created by handling. The soil when observed in the horizon did not have distinct units
of structure and should have been reported as "massive ".
Added notation: on 4/23/04 Mark Iverson (Cedar Corp. certified professional soil scientist),
Shaun Bird, and myself did an evaluation of soils on Lots 6 & 9, Richmond Meadows where the
original soil report described the third horizon as sandy loam, "I mgr". On Lot 6 we checked
soil profiles within a POWTS distribution cell and then excavated a test pit on Lot 9. The sandy
loams in question were a weak, coarse to very coarse subangular blocky structure, where planes
of weakness were just discernible when peds were parted from the profile. The peds separated
with very light pressure by soil tester. Sand coatings were observed on the ped faces in the Lot 9
soils, which supported the determination that some structure existed to allow water to move
through the upper portion of the sandy loam horizon. However, below the weak - structured soil
we found massive (structureless) sandy loams and the boundary between these horizons was
irregular, which would mean a distribution cell could encounter alternating weak and massive
sandy loam. Shaun said he would amend his soil reports with a memo recommending that any
sandy loams he identified as "lmgr" or "2 mgr" be assigned a lower loading rate of 0.3 gpd/ft2
(see attached memo for Whitetail Meadows) to provide a larger dispersal area.
Page Two — Soil Memo 4/27/04
Massive sandy loams have been assigned a soil application rate of 0.2 gpd/ft with the code
changes in Comm 83.44 -2, effective as of 2/1/04. The application rates listed on the soil reports
were higher due to the structure having been described as either weak or moderate, which affects
the calculations for sizing of POWTS distribution cells. Obviously, one of the concerns is to
make sure loading rates for the soils are not in error and allow undersized POWTS to be
installed. For example, in December 2003, Lot 35 of Richmond Meadows subdivision had to
have its loading rate reduced to 0.3 gpd/sq. ft. when the installer encountered massive sandy
loam at the system elevation. The sandy loam horizon had been described on the soil report as
"I mgr" with firm consistence.
Leroy Jansky, Dept. of Commerce Regional Wastewater Specialist, has been consulted on this
situation and advised the zoning department to require on -site verifications for any lots with this
potential misinterpretation on the soil reports. All soil reports with sandy loam "1 or 2 mgr" as
its structure will be required to use a design based on the current code's soil application rate for
massive sandy loam @ 0.2 gpd/sq. ft. unless additional soil testing proves otherwise.
Wisconsin Department of commerce SOIL EVALUATION REPORT Page / of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must County 1-1 , 1 !
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. L
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. view � D at
Personal information you provide maj i; used far secondary purposes Law, s. 15.04 (1) (m)). ( 7 V
Property Owner Property Location
.5 c , /� � j y Govt. Lot
T' 1/ iA S Z T N R I E (o W
Property Ow Mai' Address Lot # Block # Subd. Name or M#
I-- s2 e-
City tale Code hone Number ❑City Village Nearest Road
New Construction Us • Residential / Number of bedroom Code derived design flow rate ,� GPD
❑ Replacement Public orm�eraal - Describe: --
Parent material Flood Plain elevati if applicable 4,!� / /I ft.
General comments / �Z� c'J E� Z, �'l'C�iYl1
and recommendations: l r � ,
s n
n Boring
Boring #
L-l- -�
Pit Ground surface elev. � � ft. Depth to limiting factor � in. Soil e
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl?
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0- Z ,- 31 Z, - — s/ ee
�- z
Re'l V
®Boring # Q, Boringl
/fl pit Ground surface elev. � ft. Depth to limiting factor � in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
-12 s--- S
2 1z -
3
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 1 150 ' Effluent #2 = BOD 1 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Si CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 5401 — 1�� O 715 - 246 -4516
Property Owner _ Parcel ID # Page Z of
Boring
F,31 Boring # ,r)
Pit
Ground surface ele . � ft. Depth to limiting factor Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
'Eff#1 'Eff#2
2
lh �SIc G t' S b �� - rn �✓ w Z 3
lo
a Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Boring
F
Boring # Ground surface elev. ft. Depth to limiting factor in.
El Pit Soil ication Rate
Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu
Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
' Effluent #1 = BOD > 30 220 mg/L and TSS >30 1150 mg/- Effluent #2 - BOD, < _ 30 mg/L and TSS < _ 30 m91L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an altemate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777.
SOD -8330 (8.6/00)
3 0J 3
Soil Test Plot Pla
Project Name William Stock/Steve Dalton Sha
Address 1748 112th St.
New Richmond Wi 54017 ITM #226900
Lot 1 Subdivision Lundy Meadows Dat 8/11/03
N 1/2 SE 1/4S 22 T 30 N /R W Township Richmond
❑ Boring 0 Well PL Property Line County S T. CROIX
BM or VRP Assume Elevation 100 ft. Top of Survey Iron
System Elevation 89. 6/89.2 *HRPSame as Benchmark
Alt. BM Top of 2" Pipe @ 100.2'
Alt. B.M.
B.M. 423' Property Line
Please note: Installer must
verify all lot lines and setbacks Scale is 1" = 40'
315' before installation.
Property unless otherwise
Line noted
Please Note: Tested area
may not be suitable for
desired building area.
Check system location
before excavating.
B -3 93'
45'
0'
B -2
80' 5' 91'
20'
5 '
B -1 6%
Slope Pro Town
Road
50'
2439P 637
MORTGAGE
Loan No: 12193109 (Continued) Page 3
Environmental Laws. The words "Environmental Laws" mean any and all state, federal and local statutes, regulations and
ordinances relating to the protection of human health or the environment, including without limitation the Comprehensive
Environmental Response, Compensation, and Liability Act of 1980, as amended, 42 U.S.C. Section 9601, at seq. ( "CERCLA "),
the Superfund Amendments and Reauthorization Act of 1966, Pub. L. No. 99-499 ( "SARA "), the Hazardous Materials
Transportation Act, 49 U.S.C. Section 1801, at seq., the Resource Conservation and Recovery Act, 42 U.S.C. Section 6901, at
seq., or other applicable state or federal laws, rules, or regulations adopted pursuant thereto.
Event of Default. The words "Event of Default" mean any of the events of default set forth in this Mortgage in the events of
default section of this Mortgage.
Grantor. The word "Grantor" means DALSTOCK, LLC.
Guarantor. The word "Guarantor" means any guarantor, surety, or accommodation party of any or all of the Indebtedness.
Guaranty. The word "Guaranty" means the guaranty from Guarantor to Lender, including without limitation a guaranty of all or
part of the Note.
Indebtedness. The word "Indebtedness" means all principal, interest, and other amounts, costs and expenses payable under the
Note or Related Documents, together with all renewals of, extensions of, modifications of, consolidations of and substitutions for
the Note or Related Documents and any amounts expended or advanced by Lender to discharge Grantor's obligations or expenses
incurred by Lender to enforce Grantor's obligations under this Mortgage, together with interest on such amounts as provided in
this Mortgage.
Lender. The word "Lender" means S & C Bank, its successors and assigns.
Mortgage. The word "Mortgage" means this Mortgage between Grantor and Lender.
Note. The word "Note" means the promissory note dated October 16, 2003, in the original principal amount of
$1,312,500.00 from Grantor to Lender, together with all renewals of, extensions of, modifications of, refinancings of,
consolidations of, and substitutions for the promissory note or agreement. NOTICE TO GRANTOR: THE NOTE CONTAINS A
VARIABLE INTEREST RATE.
Personal Property. The words "Personal Property" mean all equipment, fixtures, and other articles of personal property now or
hereafter owned by Grantor, and now or hereafter attached or affixed to the Real Property; together with all accessions, parts,
and additions to, all replacements of, and all substitutions for, any of such property; and together with all proceeds (including
without limitation all insurance proceeds and refunds of premiums) from any sale or other disposition of the Property.
Property. The word "Property" means collectively the Real Property and the Personal Property.
Real Property. The words "Real Property" mean the real property, interests and rights, as further described in this Mortgage.
Related Documents. The words "Related Documents" mean all promissory notes, credit agreements, loan agreements,
environmental agreements, guaranties, security agreements, mortgages, deeds of trust, security deeds, collateral mortgages, and
all other instruments, agreements and documents, whether now or hereafter existing, executed in connection with the
Indebtedness.
Rents. The word "Rents" means all present and future rents, revenues, income, issues, royalties, profits, and other benefits
derived from the Property.
GRANTOR ACKNOWLEDGES HAVING READ ALL THE PROVISIONS OF THIS MORTGAGE, AND GRANTOR AGREES TO ITS TERMS.
GRANTOR
DALSTOCK LL
ey.
WILLM B STOCK MEMBER of DALSTOCK, LLC
By.
STEVEN M DALTON, MEMBER of DALSTOCK, LLC
This Mortgage prepared by: X
Name of Signer: SUE SLOMQUIST
Complete either Authentication Section or Acknowledgment Section
AUTHENTICATION
Signature(s) of DALSTOCK, LLC authenticated this day of 20
Title: Member State Bar of Wisconsin or
authorized under Section 706.06, Wis. Stats.
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer / /o GT C, L L C '
Mailing Address / 7 V� /a 7 r
Property Address / a 9 'tA' S 7 —
(Verification required from Planning Department for new construction)
City/State W- Parcel Identification Number
LEGAL DESCRIPTION L -
Y ✓f r �1 -R � W
Property Location /4, Sec. � T�. , Town of
Subdivision l a�� Lot #
Certified Survey Map # _ , Volume . Page # -
Warranty Deed # :2 L , Volume Page #
S p ec house g y es O no Lot lines identifiable yes 0 no
SYSTEM MAINTENANCE �p D V
Improper use and maintenance of your septic system could result in its premature zii= to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
mastcrplumber, journeyman plumber, restricted plumber or a li cense d pum verifying that (1) the on-site wastewaterdisposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 15 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the ent of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septi tem has maintained must be completed and returned to the St. Croix County Zoning Office within 30
days of the three y p' o e.
�; /l�� � d W Wit✓ �— Sl �� � � / /� d
SIGNA m Q ATE
R CERTIFICATION �Q
OWNER
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of
the property d a46o , by ' e c& a warranty deed recorded in Register of Deeds Office.
SIGNA OF APPL a DATE
* « « « *« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.****
** Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of y
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner 1 c Septic Tank Capacity 60 gal ❑ NA
Permit # Septic Tank Manufacturer ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Modeler ❑ NA
Number of Public Facility Units ❑ NA Pump Tank Capacity a l ❑ NA
Estimated flow (average)��. al /day Pump Tank Manufacturer ❑ NA
Design flow (peak), (Estimated x 1.5) U— al /da Pump Manufacturer ❑ NA
Soil Application Rate s Pump Model ❑ NA
� /day /ft
Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ❑ NA
Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) :5150 mg /L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BOD 530 mg /L - Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) :530 mg /L L�" NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) 510" /100m1 /` ❑Drip -Line ❑Other:
Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA
Other: ❑ NA Other: ❑ NA
* Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) 11 NA
ear(s)
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA
Inspect dispersal cell(s) At least once every: ❑ ea��s(s) (Maximum 3 years) ❑ NA
Clean effluent filter A5 � D£D _� At least once every: ❑ ye ar(s ) ❑ NA
❑ month(s) ❑ NA
Inspect pump, pump controls & alarm At least once every: ❑ year(s)
❑ month(s) ❑ NA
Flush laterals and pressure test At least once every: ❑ year(s)
Other: At least once every: ❑ month(s) ❑ NA
❑ year(s)
Other: ❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
GMW (4/01)
Page Z of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS
technology a holdin tank may be installed as a last resort to replace the failed POWTS.
The si e s not e n evaluat o identify a s replacement a. pon failur he POWTS a soil and site
valua i us e p rform to to ate a sui le repla ement ar . If nor ent area available a holding tank
ay b ns a d as a as sort to re lace a failed PO
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER bG
Name v� c9l/I ,�L ��' Name
Phone 7 Phone S
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name �� �^ Name S� G ro
Phone ,;;? l I I Phone 3 �
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.540 ), (2) & (3), Wisconsin Administrative Code.
09 /12 00
24 1.10 1 ?15246249_2 BILLSTOCK PAC,
- y
U 2 934 - 7�.�.�r��
STATF BAR OF w't5C(iNSIh Fi 1R?�1 1 - 20pCt KATHLEEN H. WALSH
REGISTER OF DEEDS
Document Number WARRANTY DEED ST. CROIX CO., WI
i RECEIVE[ FOR RECORD
This Deed, made between L. Lawrence Williams and Vir ina R. I 10/21/2003 09; 45AN
Williams husband and wife and each in their own right Grantor, and
Clalstock LLC, a Wisconsin limited liability company Grantee- WARRANTY DEED
j Grantor, for a valuable consideration, conveys to Grantee the following tiEMFT
described real estate in St. Croix County, State of Wisconsin (the "Property") REC FEE: 11.00
(if more space is needed, please attach addendum): TRANS FEE: 3015, 00
The South One -half of the Northwest Quarter (S "A of NW : of Section COPY FEE:
Twenty -three (23), Township Thirty (30) North, Range Eighteen (18) West, CC FEE:
i EXCEPT Lot One (1) of Certified Survey Ma recorded in Vol. 8 of PAGES: 1
C — erfiffli — ed Survey Maps, Page 23 S 465057;
The North One -half of the Southeast Quarter (N two of SE !4) of Section
Twenty -two (22 },Township Thlriy (30) North, Range Eighteen (18) West.
).rding Area
"irgtnla I Lams joins in this ee rose of conveying any
interest she may hati a in the suhjact proper under the *lNrits rop y .xws 4,t.11 „1u Rc:urn :1od;ess
of the State of Wisconsin. Robert J. Richardson
Parcel Id numbers: Bakke Norman, c f
026- 1068 -80 -000; 026- 1068 -90 -000; 07,6 - 1066 -80 -000; 026. 1066.90 -400 S233 McKay Ave., P.O. Box 399
i Spring Valley, WI 54767
I
Together with all appurtenant rights, titio and interests. See above
Parcel Identification Number ('PIN)
This is not hornestead property
40 (is not)
Cirantc r warrants that the title to the Propert) is good, indefeasible in fee simple and free and clear of encumbrances except:
easements, restrictions and rights of war of record
Dated this 15th day of 0 ' er, 2003
L. Lawrence Williams Virg{ is R. Williams
AUTHENTICATION 1CIC ;Ol�'LEUC; s71:ti T
Si¢nati:re(si L. LHwre_nce Williams and STATE OF WISCONSIN )
Virgins R. Williams ) ss.
County )
authenticated this 75th da f October ' 2003
_ Personally came before me this day of
2003 the above named
ob rt J. Richardson
TF LE: MEMBER STATE BAR OF w'ISCONSIN --
(If not, to me known to be the nerson(s) who executed the forewiniz
authorized by U106.06, Wis Stats l instrument and acknowledged the same.
THIS INSTRUMENT WAS DRAFTED B 'Y'
ROBERT J. RICHARDSON, Bakke Norman. SC • _ _
SPRINtr VALLEN'. WI 5476" Notary Public, Statc of
My Commission is permanent. ('If not, state expiration date:
(Signatures may he authenticated or acknowledged. 8rith are nit necessary.) )
"�arr)es of perions signing in any Capacity must be r) prd Or printed below their signature. ('vFQ•PRO l809)055 -2021 w , v infblrrofnrms.corrSTATE BAFt i1P w'ISCO
%'ARRANT% nFF,.D FORM No. I - 2060
w '
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PROJ. NO. 90 -74
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Vol. 8 Page 2305
"I r 1J 1 ; MEADOWS SW
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140Th AVENUE r c I Q I
1� I
LOT 19
SEC. 2 Y M A P W. I I 120
TOWN OF RICHMOND, ST. CROIX COUNTY, WI East 114 Corner
NOT TO SCALE Section 22- ,30 -18 I
I (found survey nail)
LOT 18 33 -, 8 40'
1
� I 2.67
Igo 66.00'
® 422.70' 67.33'
LOT I • • N
68, 036 sq. ft:
LOT 2 1.56 acres X
_ U
7 4,877 sq. ft. �� . • • (j3 / C j / .�� I Z 1
1.72 acres ,
0.0 66' Joint p�(�; G J 1
F Driveway I � 6$• �W I� `/ 1
Easement / • , / ;
(TfflkG /) / S69 pW � I w
569,53 �3' / I o Q
TOTS G �, / // ; I x
.985 sq. ft : ti / LOT 36 I
.54 acres
/ .109, 894 sq. ft.
• / / // • • 2.52 acres 11
D.O. T. Setbock (50' I =)
from Right -of -Way) •Q� I
49 3720 E 229.05 /
LU
County Building I v
• 1 Setback (100' from -& - :I
® 13 0) ZZ Right -of- -Way) A x
S 8731 '02" W 325.69 = h
LOT4
68,672 sq. ft. .
0 1.58 acres ss� 42 3s E • ' I I I k
v 14.84 N
LOT 3S N o
• °'� 66, 001 sq. ft. : z 4 4 W
/ N 1.52 acres'
- / 3�_ �3 337 n n